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Pharms > UTI's > Flashcards

UTI's Flashcards

1
Q

Ciprofloxacin side effects

A
  • musculoskeletal - tendonitis, tendon rupture (athletes)

- CNS disturbance - seizures with pre-existing CNS disorders

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2
Q

Ciprofloxacin interactions

A

CYP450 inhibitor

  • rifampicin antagonist
  • NSAIDS and Phenytoin
  • antacids
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3
Q

Cephalosporins (UTI)

A
  • first line in pregnancy
  • ceftriaxone, cefpodoxime, cefipime
  • time-dependent
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4
Q

Cefpodoxime side effects

A

-Neurotoxicity (hallucination, convulsion)

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5
Q

Cefpodoxime interactions

A
  • Warfarin (potentiates)
  • Probenecid (decreased cefpodoxime concentration in urine)
  • alcohol (extreme hangover)
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6
Q

Penicillin (UTI)

A
  • 2nd line in pregnancy
  • Co-amoxiclav (amoxicillin + clavulanic acid)
  • time-dependent
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7
Q

Amoxicillin interactions

A
  • oral contraceptives
  • allopurinol - increased risk of rash
  • warfarin (potentiates)
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8
Q

Co-trimoxazole (UTI)

A
  • in case of penicillin allergy
  • sulphamethoxazole (inhibits PABA incorporation)
  • trimethoprim (dihydrofolate reductase)
  • inhibits tetrahydrofolic acid synthesis
  • t1/2 = 9h
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9
Q

Co-trimoxazole side effects (UTI)

A

-hyperkalemia - trimethoprim
Sulphamethoxazole:
-hypersensitivity (Stevens Johnson syndrome, rash)
-Infectious diarrhea (pseudomembranous colitis - C. difficile)

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10
Q

Co-trimoxazole contraindications (UTI)

A
  • pregnancy

- infants

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11
Q

Co-trimoxazole interactions (UTI)

A
  • alcohol (trimethoprim)
  • Digoxin, phenytoin (increased plasma concentration)
  • Warfarin, sulphonylureas (potentiates)
  • Zidovudine (increased toxicity)
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12
Q

Fosfomycin

A
  • acute uncomplicated lower UTI’s of females >5y
  • broad spectrum
  • single mega dose (resistance develops quickly)
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13
Q

Fosfomycin side effects & contraindications

A
  • GIT disturbances (diarrhoea, vomiting)
  • Hypersensitivity (rashes, hives)
  • interacts with metoclopramide (decreases concentration of fosfomycin)
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14
Q

Nitrofurantoin

A
  • uncomplicated lower UTI’s
  • not effective against Pseudomonas or Proteus
  • resistance develops quickly
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15
Q

Nitrofurantoin side effects

A
  • Pulmonary - fibrosis
  • Allergies (rash, hives)
  • CNS disturbance (headaches, nausea, nystagmus)
  • Neurotoxicity (peripheral neuropathy)
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16
Q

Nitrofurantoin contraindications

A
  • pregnant females (hemolytic anemia in fetus)

- do not use in renal impairment

17
Q

Nitrofurantoin interactions

A
  • Levlonumide
  • Probenecid
  • Quinolones
  • Minerals
18
Q

Aminoglycosides (UTI)

A
  • for multi-drug resistant UTI’s only
  • in combination with B-lactam (synergy)
  • Gentamicin, Tobramycin, Amikacin
  • inhibits protein synthesis
  • IV or IM administration
19
Q

Gentamicin side effects

A
  • ototoxicity
  • nephrotoxicity
  • neuromuscular blockade
20
Q

Gentamicin contraindications

A
  • pregnancy (affects development of 8th cranial nerve)

- myasthenia gravis - increased risk of neuromuscular blockade

21
Q

Gentamicin interactions

A
  • muscle relaxants (potentiates)

- nephrotoxic drugs (loop diuretics etc) - increased effect

22
Q

Imipenem/Cilastatin

A
  • for complicated/nosocomial UTI’s

- cilastatin inhibits dehydropeptidases (degrade imipenem)

23
Q

Imipenem/Cilastatin side effects

A
  • CNS disturbances - seizures

- allergic reaction (rash)

24
Q

Imipenem/Cilastatin interactions

A
  • Tramadol
  • Valproic acid
  • Bupropion
  • Fluoroquinolones
25
Q

Piperacillin/Tazobactam

A
  • Complicated/nosocomial UTI’s
  • Piperacillin: inhibits cell wall sythesis (sensitive to B-lactamases)
  • Tazobactam: inhibits B-lactamase
  • synergystic with aminoglycosides against Ps. aeruginosa
26
Q

Piperacillin/Tazobactam side effects and interactions

A
  • similar to other penicillins

- interacts with probenecid (decreased urinary excretion)

27
Q

Quinolones (UTI)

A
  • ciprofloxacin, ofloxacin - treat uncomplicated UTI’s
  • inhibit DNA gyrase - inhibit DNA replication
  • do not give to pregnant females or children

Pharms (5 decks)

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